Share to Facebook Share to X Share to LinkedIn Share to Email Download the PDF version of this form You must have JavaScript enabled to use this form. Intro Please complete this form to request a speaker from the IPC for your event. We recommend that you submit your request at least two months prior to the event to allow enough time for our office to review and respond to your request. Provide the details of your event below.If you are not able to use the form below, you may print and fill out a PDF version, and send it to [email protected].Commissioner media kit Event details Event name Date Time Location Address City Postal code Website Topic Attach any relevant documents/agenda below. Attachments One file only.100 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Type In person Webinar Video (e.g. Skype) Other… Enter other… Format Keynote/Plenary Concurrent Panel Other… Enter other… Panelists/Speakers If applicable, please list any other panelists and/or speakers that are attending. Audience size Demographics (i.e. profession/knowledge level) Preferred speaker Will accept another speaker if preferred speaker is unavailable Additional comments Contact information Contact name Organization Telephone Email CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank
Share to Facebook Share to X Share to LinkedIn Share to Email Download the PDF version of this form You must have JavaScript enabled to use this form. Intro Please complete this form to request a speaker from the IPC for your event. We recommend that you submit your request at least two months prior to the event to allow enough time for our office to review and respond to your request. Provide the details of your event below.If you are not able to use the form below, you may print and fill out a PDF version, and send it to [email protected].Commissioner media kit Event details Event name Date Time Location Address City Postal code Website Topic Attach any relevant documents/agenda below. Attachments One file only.100 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Type In person Webinar Video (e.g. Skype) Other… Enter other… Format Keynote/Plenary Concurrent Panel Other… Enter other… Panelists/Speakers If applicable, please list any other panelists and/or speakers that are attending. Audience size Demographics (i.e. profession/knowledge level) Preferred speaker Will accept another speaker if preferred speaker is unavailable Additional comments Contact information Contact name Organization Telephone Email CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank
